Display options
Cite
Krul SPJ, Berger WR, Veldkamp MW, et al. Treatment of Atrial and Ventricular Arrhythmias Through Autonomic Modulation. JACC Clin Electrophysiol. 2015;1(6):496-508doi: 10.1016/j.jacep.2015.09.013.
Krul, S. P. J., Berger, W. R., Veldkamp, M. W., Driessen, A. H. G., Wilde, A. A. M., Deneke, T., de Bakker, J. M. T., Coronel, R., & de Groot, J. R. (2015). Treatment of Atrial and Ventricular Arrhythmias Through Autonomic Modulation. JACC. Clinical electrophysiology, 1(6), 496-508. https://doi.org/10.1016/j.jacep.2015.09.013
Krul, Sébastien P J, et al. "Treatment of Atrial and Ventricular Arrhythmias Through Autonomic Modulation." JACC. Clinical electrophysiology vol. 1,6 (2015): 496-508. doi: https://doi.org/10.1016/j.jacep.2015.09.013
Krul SPJ, Berger WR, Veldkamp MW, Driessen AHG, Wilde AAM, Deneke T, de Bakker JMT, Coronel R, de Groot JR. Treatment of Atrial and Ventricular Arrhythmias Through Autonomic Modulation. JACC Clin Electrophysiol. 2015 Dec;1(6):496-508. doi: 10.1016/j.jacep.2015.09.013. Epub 2015 Oct 24. PMID: 29759403.
Copy Download .nbib Format: NLM
Share it on

JACC Clin Electrophysiol. 2015 Dec;1(6):496-508. doi: 10.1016/j.jacep.2015.09.013. Epub 2015 Oct 24.

Treatment of Atrial and Ventricular Arrhythmias Through Autonomic Modulation.

JACC. Clinical electrophysiology

Sébastien P J Krul, Wouter R Berger, Marieke W Veldkamp, Antoine H G Driessen, Arthur A M Wilde, Thomas Deneke, Jacques M T de Bakker, Ruben Coronel, Joris R de Groot

Affiliations

  1. Heart Center, Department of Clinical and Experimental Cardiology, Academic Medical Center, Amsterdam, the Netherlands.
  2. Heart Center, Department of Clinical and Experimental Cardiology, Academic Medical Center, Amsterdam, the Netherlands; Princess Al-Jawhara Al-Brahim Centre of Excellence in Research of Hereditary Disorders, Jeddah, Kingdom of Saudi Arabia.
  3. Heart Center Bad Neustadt, Bad Neustadt a.d. Saale, Germany.
  4. Heart Center, Department of Clinical and Experimental Cardiology, Academic Medical Center, Amsterdam, the Netherlands; Interuniversity Cardiology Institute of the Netherlands, Utrecht, the Netherlands.
  5. Heart Center, Department of Clinical and Experimental Cardiology, Academic Medical Center, Amsterdam, the Netherlands; L'Institut de RYthmologie et de modélisation Cardiaque (LIRYC), Université Bordeaux Segalen, Bordeaux, France.
  6. Heart Center, Department of Clinical and Experimental Cardiology, Academic Medical Center, Amsterdam, the Netherlands. Electronic address: [email protected].

PMID: 29759403 DOI: 10.1016/j.jacep.2015.09.013

Abstract

This paper reviews the contribution of autonomic nervous system (ANS) modulation in the treatment of arrhythmias. Both the atria and ventricles are innervated by an extensive network of nerve fibers of parasympathetic and sympathetic origin. Both the parasympathetic and sympathetic nervous system exert arrhythmogenic electrophysiological effects on atrial and pulmonary vein myocardium, while in the ventricle the sympathetic nervous system plays a more dominant role in arrhythmogenesis. Identification of ANS activity is possible with nuclear imaging. This technique may provide further insight in mechanisms and treatment targets. Additionally, the myocardial effects of the intrinsic ANS can be identified through stimulation of the ganglionic plexuses. These can be ablated for the treatment of atrial fibrillation. New (non-) invasive treatment options targeting the extrinsic cardiac ANS, such as low-level tragus stimulation and renal denervation, provide interesting future treatment possibilities both for atrial fibrillation and ventricular arrhythmias. However, the first randomized trials have yet to be performed. Future clinical studies on modifying the ANS may not only improve the outcome of ablation therapy but may also advance our understanding of the manner in which the ANS interacts with the myocardium to modify arrhythmogenic triggers and substrate.

Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Keywords: atrial fibrillation; autonomic nervous system; catheter ablation; renal denervation; stellate ganglion ablation; vagal stimulation; ventricular arrhythmias

Publication Types